Open Journal Systems

Cover Image

Peri-implant diseases: Treatment and management

Sara Samizade, Mozhgan Kazemian, Sajedeh Ghorbanzadeh, Parvin Amini

Abstract


One of the substantial changes in dentistry is the development of implant science. Along with the development of applications, implant science practitioners will face an inevitable challenge, which is how to deal with such problems. Recently conducted researches are more concentrated on surgical and prosthetic techniques, while the treatment for peri-implant diseases is still incomplete. Therefore, the aim of this review research is to provide a broad and descriptive overview on peri-implant diseases and to suggest the related treatments. Scientific articles were collected by electronic searching through EMBASE and Medline, and since controlled clinical trials were limited in this field, no limitation was imposed on the evaluated articles. Moreover, review articles and meta-analysis were used. For implants that bone resorption has affected <50% of the implant length, the evaluation is thoroughly recommended. Regarding cases with a range of <2 mm, the treatment plan will be more inclined towards non-surgical methods and should be treated by Peri-implant mucositis. If the bone resorption is >2 mm, surgical methods are proved to be more effective and in the cases which has extended >50% of the implant length, it is better to remove the implant. By increasing the range of annual dental implant, peri-implant diseases have become a serious challenge in this field. The proposed treatment plan will be a manual for dentists regarding on how to deal with implant problems; although further researches are required to approve the proposed protocols.


Keywords


Dental implant; disease; peri-implant inflammation

Full Text:

ABSTRACT PDF

References


Patel RR, Richards PS, Inglehart MR. Periodontal health, quality of life, and smiling patterns – An exploration. J Periodontol 2008;79:224-31.

Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002;29 Suppl 3:197-212.

Balshi SF, Wolfinger GJ, Balshi TJ. A prospective study of immediate functional loading, following the teeth in a Day™ protocol: A case series of 55 consecutive edentulous maxillas. Clin Implant Dent Relat Res 2005;7:24-31.

Friberg B, Henningsson C, Jemt T. Rehabilitation of edentulous mandibles by means of turned brånemark system implants after one-stage surgery: A 1-year retrospective study of 152 patients. Clin Implant Dent Relat Res 2005;7:1-9.

Rosenberg ES, Torosian JP, Slots J. Microbial differences in 2 clinically distinct types of failures of osseointegrated implants. Clin Oral Implants Res 1991;2:135-44.

Montes CC, Pereira FA, Th omé G, Alves ED, Acedo RV, de Souza JR, et al. Failing factors associated with osseointegrated dental implant loss. Implant Dent 2007;16:404-12.

Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: A review of the literature. Clin Oral Implants Res 2002;13:1-19.

Wennström JL, Ekestubbe A, Gröndahl K, Karlsson S, Lindhe J. Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. A 5-year prospective study. J Clin Periodontol 2004;31:713-24.

Chung DM, Oh TJ, Lee J, Misch CE, Wang HL. Factors affecting late implant bone loss: A retrospective analysis. Int J Oral Maxillofac Implants 2007;22:117-26.

Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant stability measurements for implants placed at the time of extraction: A cohort, prospective clinical trial. J Periodontol 2005;76:391-7.

Tonetti MS, Schmid J. Pathogenesis of implant failures. Periodontol 2000 1994;4:127-38.

Misch CE, Perel ML, Wang HL, Sammartino G, Galindo- Moreno P, Trisi P, et al. Implant success, survival, and failure: The International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 2008;17:5-15.

Tonetti MS. Risk factors for osseodisintegration. Periodontol 2000 1998;17:55-62.

Reiser GM, Nevins M. Th e implant periapical lesion: Etiology, prevention, and treatment. Compend Contin Educ Dent 1995;16:768, 770.

Becker W, Becker BE, Newman MG, Nyman S. Clinical and microbiologic findings that may contribute to dental implant failure. Int J Oral Maxillofac Implants 1990;5:31-8.

Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, et al. Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol 1988;59:287-96.

Krauser JT. Hydroxylapatite-coated dental implants. Biologic rationale and surgical technique. Dent Clin North Am 1989;33:879-903.

Esposito M, Hirsch J, Lekholm U, Thomsen P. Differential diagnosis and treatment strategies for biologic complications and failing oral implants: A review of the literature. Int J Oral Maxillofac Implants 1999;14:473-90.

Lindhe J, Berglundh T, Ericsson I, Liljenberg B, Marinello C. Experimental breakdown of peri-implant and periodontal tissues. A study in the beagle dog. Clin Oral Implants Res 1992;3:9-16.

Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991;2:81-90.

Roos-Jansåker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year follow-up of implant treatment. Part II: Presence of peri-implant lesions. J Clin Periodontol 2006;33:290-5.

Fransson C, Lekholm U, Jemt T, Berglundh T. Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res 2005;16:440-6.

Baelum V, Ellegaard B. Implant survival in periodontally compromised patients. J Periodontol 2004;75:1404-12.

Fransson C, Wennström J, Berglundh T. Clinical characteristics at implants with a history of progressive bone loss. Clin Oral Implants Res 2008;19:142-7.

Mombelli A, Lang NP. The diagnosis and treatment of peri-implantitis. Periodontol 2000 1998;17:63-76.

Rams TE, Roberts TW, Tatum H Jr, Keyes PH. The subgingival microbial fl ora associated with human dental implants. J Prosthet Dent 1984;51:529-34.

Quirynen M, Vogels R, Peeters W, van Steenberghe D, Naert I, Haffajee A. Dynamics of initial subgingival colonization of ‘pristine’ peri-implant pockets. Clin Oral Implants Res 2006;17:25-37.

Agerbaek MR, Lang NP, Persson GR. Comparisons of bacterial patterns present at implant and tooth sites in subjects on supportive periodontal therapy. I. Impact of clinical variables, gender and smoking. Clin Oral Implants Res 2006;17:18-24.

Gerber J, Wenaweser D, Heitz-Mayfi eld L, Lang NP, Persson GR. Comparison of bacterial plaque samples from titanium implant and tooth surfaces by different methods. Clin Oral Implants Res 2006;17:1-7.

Leonhardt A, Renvert S, Dahlén G. Microbial findings at failing implants. Clin Oral Implants Res 1999;10:339-45.

Renvert S, Roos‐Jansåker AM, Lindahl C, Renvert H, Persson GR. Infection at titanium implants with or without a clinical diagnosis of inflammation. Clin Oral Implants Res 2007;18:509-16.

Koka S, Razzoog ME, Bloem TJ, Syed S. Microbial colonization of dental implants in partially edentulous subjects. J Prosthet Dent 1993;70:141-4.

Sato J, Gomi K, Makino T, Kawasaki F, Yashima A, Ozawa T, et al. The evaluation of bacterial fl ora in progress of peri-implant disease. Aust Dent J 2011;56:201-6.

Pjetursson BE, Helbling C, Weber HP, Matuliene G, Salvi GE, Brägger U, et al. Peri-implantitis susceptibility as it relates to periodontal therapy and supportive care. Clin Oral Implants Res 2012;23:888-94.

Pontoriero R, Tonelli MP, Carnevale G, Mombelli A, Nyman SR, Lang NP. Experimentally induced peri-implant mucositis. A clinical study in humans. Clin Oral Implants Res 1994;5:254-9.

Salcetti JM, Moriarty JD, Cooper LF, Smith FW, Collins JG, Socransky SS, et al. The clinical, microbial, and host response characteristics of the failing implant. Int J Oral Maxillofac Implants 1997;12:32-42.

Roos-Jansåker AM, Renvert S, Egelberg J. Treatment of peri-implant infections: A literature review. J Clin Periodontol 2003;30:467-85.

Trejo PM, Bonaventura G, Weng D, Caff esse RG, Bragger U, Lang NP. Effect of mechanical and antiseptic therapy on peri-implant mucositis: An experimental study in monkeys. Clin Oral Implants Res 2006;17:294-304.

Felo A, Shibly O, Ciancio SG, Lauciello FR, Ho A. Effects of subgingival chlorhexidine irrigation on peri-implant maintenance. Am J Dent 1997;10:107-10.

Strooker H, Rohn S, Van Winkelhoff AJ. Clinical and microbiologic effects of chemical versus mechanical cleansing in professional supportive implant therapy. Int J Oral Maxillofac Implants 1998;13:845-50.

Ciancio SG, Lauciello F, Shibly O, Vitello M, Mather M. The effect of an antiseptic mouthrinse on implant maintenance: Plaque and peri-implant gingival tissues. J Periodontol 1995;66:962-5.

Schenk G, Flemmig TF, Betz T, Reuther J, Klaiber B. Controlled local delivery of tetracycline HCl in the treatment of peri-implant mucosal hyperplasia and mucositis. A controlled case series. Clin Oral Implants Res 1997;8:427-33.

Porras R, Anderson GB, Caff esse R, Narendran S, Trejo PM. Clinical response to 2 diff erent therapeutic regimens to treat peri-implant mucositis. J Periodontol 2002;73:1118-25.

Schär D, Ramseier CA, Eick S, Arweiler NB, Sculean A, Salvi GE. Anti-infective therapy of peri-implantitis with adjunctive local drug delivery or photodynamic therapy: Six-month outcomes of a prospective randomized clinical trial. Clin Oral Implants Res 2013;24:104-10.

Behneke A, Behneke N, d’Hoedt B. Treatment of peri-implantitis defects with autogenous bone graft s: Six-month to 3-year results of a prospective study in 17 patients. Int J Oral Maxillofac Implants 2000;15:125-38.

Tinti C, Parma-Benfenati S. Treatment of peri-implant defects with the vertical ridge augmentation procedure: A patient report. Int J Oral Maxillofac Implants 2001;16:572-7.

Suh JJ, Simon Z, Jeon YS, Choi BG, Kim CK. The use of implantoplasty and guided bone regeneration in the treatment of peri-implantitis: Two case reports. Implant Dent 2003;12:277-82.

Büchter A, Meyer U, Kruse-Lösler B, Joos U, Kleinheinz J. Sustained release of doxycycline for the treatment of peri-implantitis: Randomised controlled trial. Br J Oral Maxillofac Surg 2004;42:439-44.

Romeo E, Lops D, Chiapasco M, Ghisolfi M, Vogel G. Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part II: Radiographic outcome. Clin Oral Implants Res 2007;18:179-87.

Esposito M, Grusovin MG, Kakisis I, Coulthard P, Worthington HV. Interventions for replacing missing teeth: Treatment of perimplantitis. Cochrane Database Syst Rev 2008;CD004970.

Roos-Jansåker AM, Renvert H, Lindahl C, Renvert S. Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: A prospective cohort study. J Clin Periodontol 2007;34:625-32.

Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J. Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodontol 2008;35:80-7.

De Smet E, Jacobs R, Gijbels F, Naert I. The accuracy and reliability of radiographic methods for the assessment of marginal bone level around oral implants. Dentomaxillofac Radiol 2002;31:176-81.

Kumar NA, Agrawal G, Agrawal A, Sreedevi B, Kakkad A. Journey from 2-D to 3-D: Implant imaging a review. Int J Contemp Dent Med Rev 2014;2014: Article ID 091114. doi:10.15713/ins.ijcdmr.13.

Oh TJ, Yoon J, Misch CE, Wang HL. The causes of early implant bone loss: Myth or science? J Periodontol 2002;73:322-33. 56. Triplett RG, Andrews JA, Hallmon WW. Management of peri-implantitis. Oral Maxillofac Surg Clin North Am 2003;15:129-38.

Karring ES, Stavropoulos A, Ellegaard B, Karring T. Treatment of peri-implantitis by the Vector system. Clin Oral Implants Res 2005;16:288-93.

Hayek RR, Araújo NS, Gioso MA, Ferreira J, Baptista- Sobrinho CA, Yamada AM, et al. Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs. J Periodontol 2005;76:1275-81.

Schwarz F, Jepsen S, Herten M, Sager M, Rothamel D, Becker J. Influence of different treatment approaches on non-submerged and submerged healing of ligature induced peri-implantitis lesions: An experimental study in dogs. J Clin Periodontol 2006;33:584-95.

Mombelli A, Lang NP. Antimicrobial treatment of peri-implant infections. Clin Oral Implants Res 1992;3:162-8.

Ericsson I, Lekholm U, Sennerby L, Holmén A. Soft tissue response to clinically contaminated and there after cleaned titanium surfaces. An experimental study in the rat. Clin Oral Implants Res 2000;11:370-3.

Mombelli A, Feloutzis A, Brägger U, Lang NP. Treatment of peri-implantitis by local delivery of tetracycline. Clinical, microbiological and radiological results. Clin Oral Implants Res 2001;12:287-94.

Salvi GE, Persson GR, Heitz-Mayfi eld LJ, Frei M, Lang NP. Adjunctive local antibiotic therapy in the treatment of peri-implantitis II: Clinical and radiographic outcomes. Clin Oral Implants Res 2007;18:281-5.

Renvert S, Lessem J, Dahlén G, Renvert H, Lindahl C. Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis: A randomized clinical trial. J Periodontol 2008;79:836-44.

Schwarz F, Sculean A, Rothamel D, Schwenzer K, Georg T, Becker J. Clinical evaluation of an Er: YAG laser for nonsurgical treatment of peri-implantitis: A pilot study. Clin Oral Implants Res 2005;16:44-52.

Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: Results from a 2-year prospective clinical study in humans. Clin Oral Implants Res 2011;22:1214-20.

Persson LG, Araújo MG, Berglundh T, Gröndahl K, Lindhe J. Resolution of peri-implantitis following treatment. An experimental study in the dog. Clin Oral Implants Res 1999;10:195-203.

Schou S, Holmstrup P, Jørgensen T, Skovgaard LT, Stoltze K, Hjørting-Hansen E, et al. Implant surface preparation in the surgical treatment of experimental peri-implantitis with autogenous bone graft and ePTFE membrane in cynomolgus monkeys. Clin Oral Implants Res 2003;14:412-22.

Leonhardt A, Dahlén G, Renvert S. Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodontol 2003;74:1415-22.

Jovanovic SA, Kenney EB, Carranza FA Jr, Donath K. The regenerative potential of plaque-induced peri-implant bone defects treated by a submerged membrane technique: An experimental study. Int J Oral Maxillofac Implants 1993;8:13-8.

Leonhardt Å, Adolfsson B, Lekholm U, Wikström M, Dahlén G. A longitudinal microbiological study on osseointegrated titanium implants in partially edentulotis patients. Clin Oral Implants Res 1993;4:113-20.

Sbordone L, Barone A, Ciaglia RN, Ramaglia L, Iacono VJ. Longitudinal study of dental implants in a periodontally compromised population. J Periodontol 1999;70:1322-9.

Mombelli A, Marxer M, Gaberthüel T, Grunder U, Lang NP. The microbiota of osseointegrated implants in patients with a history of periodontal disease. J Clin Periodontol 1995;22:124-30.

Mengel R, Stelzel M, Hasse C, Flores-de-Jacoby L. Osseointegrated implants in patients treated for generalized severe adult periodontitis. An interim report. J Periodontol 1996;67:782-7.

Mengel R, Flores-de-Jacoby L. Implants in patients treated for generalized aggressive and chronic periodontitis: A 3-year prospective longitudinal study. J Periodontol 2005;76:534-43.

Schou S. Implant treatment in periodontitis-susceptible patients: A systematic review. J Oral Rehabil 2008;35 Suppl 1:9-22.

Quirynen M, Abarca M, Van Assche N, Nevins M, van Steenberghe D. Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis. J Clin Periodontol 2007;34:805-15.

Lekholm U, Adell R, Lindhe J, Brånemark PI, Eriksson B, Rockler B, et al. Marginal tissue reactions at osseointegrated titanium fixtures. (II) A cross-sectional retrospective study. Int J Oral Maxillofac Surg 1986;15:53-61.

Lang NP, Wetzel AC, Stich H, Caff esse RG. Histologic probe penetration in healthy and inflamed peri-implant tissues. Clin Oral Implants Res 1994;5:191-201.

Schou S, Holmstrup P, Stoltze K, Hjørting-Hansen E, Fiehn NE, Skovgaard LT. Probing around implants and teeth with healthy or infl amed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis). Clin Oral Implants Res 2002;13:113-26.

Kullman L, Al-Asfour A, Zetterqvist L, Andersson L. Comparison of radiographic bone height assessments in panoramic and intraoral radiographs of implant patients. Int J Oral Maxillofac Implants 2007;22:96-100.

Nguyen-Hieu T, Borghetti A, Aboudharam G. Peri-implantitis: From diagnosis to therapeutics. J Investig Clin Dent 2012;3:79-94.

Prashanti E, Sajjan S, Reddy JM. Failures in implants. Indian J Dent Res 2011;22:446-53.

Aljateeli M, Fu JH, Wang HL. Managing peri-implant bone loss: Current understanding. Clin Implant Dent Relat Res 2012;14 Suppl 1:e109-18.


Refbacks

  • There are currently no refbacks.
x
Message